What Is Gluten and Will It Harm My Liver?

Nicole Cutler, L.Ac., MTCM, Dipl. Ac. (NCCAOM)®

Apr 1st, 2010

Further confirming nutrition’s role in liver health, many are experiencing a connection between gluten intolerance and liver disease.

Have you noticed the growing section of gluten-free options in your local supermarket? If you have liver disease and think that these specialty foods are just for those with a diagnosed case of Celiac disease – think again. As more is learned about intolerance or sensitivity to gluten-containing products, the more clinicians believe foods containing this protein may accelerate certain individual’s liver disease.

What is Celiac Disease?

Celiac disease is a digestive disorder that damages the small intestine and interferes with the normal absorption of nutrients from food. It arises from an allergic reaction to gluten, a protein found in wheat, rye, barley, oats and spelt.

In susceptible people, the body’s immune system reacts to gluten and injures the intestinal lining. However, substantial evidence now shows that gluten can cause health effects in other parts of the body, especially the liver. Celiac disease often goes undetected because its most common symptoms (abdominal pain, fatigue and diarrhea) are similar to a range of other disorders.

Aside from being one of the most under-diagnosed problems, Celiac disease is one of the most common chronic health disorders in Western countries. Up until 10 years ago, medical schools taught that Celiac disease was relatively rare and only affected about 1 in 2,500 people. However, more recent studies and advances in diagnosis show that at least 3 million Americans – or about 1 in 133 people have Celiac disease – but only 1 in 4,700 is ever diagnosed.

Gluten Intolerance

Although statistics show that Celiac is not extremely common, more healthcare practitioners are recognizing that sensitivity to gluten is increasingly widespread. Gluten intolerance is a broad term, which includes all kinds of sensitivity to gluten. While just a small proportion of gluten intolerant people will test positive for Celiac disease, as many as 1 in every 7 people have difficulty absorbing gluten.

Proving to make up a growing number of healthcare visits, the correct term for these people is Non-Celiac Gluten Sensitive (NCGS). Thankfully, there is a solution for those with Celiac or NCGS. Although it requires education and commitment, eliminating all foods containing gluten from the diet effectively stops symptoms and allows the areas damaged by gluten to recover.

Why Gluten Intolerance Harms the Liver

Although not everyone with liver disease has gluten intolerance, clinicians aware of the connection between the two are reporting that their co-existence is more prevalent than previously thought. Gluten damages the liver through two mechanisms: permeability and toxicity.

Permeability – In those with gluten intolerance, gluten causes the intestinal lining to become inflamed and leaky. Since the lining has more permeability, larger molecules of digested food that are normally excreted leak across the intestinal lining into the bloodstream. Once in the blood, the immune system sees these large molecules as foreign material and launches an attack against them. This immune response is systemic and can attack liver tissue in addition to the unwanted molecules. This attack on the liver releases liver enzymes, causes inflammation and can even progress to liver scarring.
Toxicity – Gluten’s irritation of the intestinal lining allows food toxins that would normally be eliminated as waste to escape into the body. Especially if someone is battling liver disease, the food toxins put a greater burden on the liver to filter them out. Consequently, a liver unable to eliminate extra toxins suffers through inflammation and damage.

Liver and Gluten Connection

Because mild liver abnormalities are common in patients with Celiac disease and usually resolve with a gluten-free diet, Finnish researchers investigated the impact of Celiac disease in patients with severe liver failure. As published in the April 2002 edition of Gastroenterology, the researchers found that a gluten-free diet could prevent progression to hepatic failure in those with dual diagnoses.

An intestinal biopsy and specific blood test are both used by physicians to diagnose Celiac disease. However, the new understanding that gluten sensitivity lies on a spectrum of ongoing pathology broadens the applicability of this Finnish study. Since those with liver disease may also have NCGS, they owe it to themselves to further investigate their relationship with gluten.

If you are like a growing number of Americans, experimenting with a gluten-free diet could result in the disappearance of gastrointestinal complaints and a normalization of liver enzymes. So instead of breezing by your market’s gluten-free section, consider a week of omitting all wheat, rye, barley and oat-containing foods from your diet. If, after one week, your health has not changed at all, there is no damage done. On the flipside, if you have fewer digestive symptoms, more energy and an improved liver panel, sticking to a gluten-free diet could single-handedly guide your liver back to a state of health.

References

http://www.celiac.com/articles/1164/1/Celiac-Disease-Statistics/Page1.html, Celiac Disease Statistics, Jefferson Adams, Retrieved March 4, 2009, Celiac.com, June 2007.

http://www.commandtheraven.com/2008/08/09/avoiding-wheat-and-gluten-may-reverse-liver-failure-and-hepatitis/, Avoiding Wheat and Gluten May Reverse Liver Failure and Hepatitis, Dr. Joseph Mercola, Retrieved March 3, 2009, Command the Raven, 2009.

http://www.foodintol.com/celiac.asp#howcommon, Gluten Intolerance and Celiac Disease, Deborah Manners BSc, Grad. Dip. Ed, Retrieved March 4, 2009, Foodintol, March 2008.

http://www.liverdisease.com/gluten_hepatitis.html, Gluten Effect on the Liver and Hepatitis, Retrieved March 3, 2009, Melissa Palmer, MD, 2009.

http://www.liverhealthtoday.org/viewarticle.cfm?aid=379, Gluten and Your Liver, Doug Childress, MD, Retrieved March 3, 2009, Liver Health Today, October-December 2008.

http://www.ncbi.nlm.nih.gov/pubmed/11910339?dopt=Abstract, Celiac disease in patients with severe liver disease: gluten-free diet may reverse hepatic failure, Gastroenterology, Kaukinen K, et al, Gastroenterology, April 2002.

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Nicole Cutler, L.Ac., MTCM, Dipl. Ac. (NCCAOM)®

Nicole Cutler, L.Ac., MTCM is a long time advocate of integrating perspectives on health. With a Bachelor's degree in Neuroscience from the University of Rochester and a Master's degree in Traditional Chinese Medicine from Five Branches Institute, Nicole has been a licensed acupuncturist since 2000. She has gathered acupuncture licenses in the states of California and New York, is a certified specialist with the National Acupuncture Detoxification Association, has earned diplomat status with the National Commission of Chinese and Oriental Medicine in Acupuncture and Chinese Herbology and is a member of the Society for Integrative Oncology. In addition to her acupuncture practice that focuses on stress and pain relief, digestion, immunity and oncology, Nicole contributes to the integration of healthcare by writing articles for professional massage therapists and people living with liver disease.